Assessing the Quality of Global Clinical Practice Guidelines on Gout Using AGREE II Instrument

et al. 2019

BMJ Open

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123

ObjectivesDespite the publication of hundreds of trials on gout and hyperuricemia, management of these conditions remains suboptimal. We aimed to assess the quality and consistency of guidance documents for gout and hyperuricemia.DesignSystematic review and quality assessment using the appraisal of guidelines for research and evaluation (AGREE) II methodology.Data sourcesPubMed and EMBASE (27 October 2016), two Chinese academic databases, eight guideline databases, and Google and Google scholar (July 2017).Eligibility criteriaWe included the latest version of international and national/regional clinical practice guidelines and consensus statements for diagnosis and/or treatment of hyperuricemia and gout, published in English or Chinese.Data extraction and synthesisTwo reviewers independently screened searched items and extracted data. Four reviewers independently scored documents using AGREE II. Recommendations from all documents were tabulated and visualised in a coloured grid.ResultsTwenty-four guidance documents (16 clinical practice guidelines and 8 consensus statements) published between 2003 and 2017 were included. Included documents performed well in the domains of scope and purpose (median 85.4%, range 66.7%–100.0%) and clarity of presentation (median 79.2%, range 48.6%–98.6%), but unsatisfactory in applicability (median 10.9%, range 0.0%–66.7%) and editorial independence (median 28.1%, range 0.0%–83.3%). The 2017 British Society of Rheumatology guideline received the highest scores. Recommendations were concordant on the target serum uric acid level for long-term control, on some indications for urate-lowering therapy (ULT), and on the first-line drugs for ULT and for acute attack. Substantially inconsistent recommendations were provided for many items, especially for the timing of initiation of ULT and for treatment for asymptomatic hyperuricemia.ConclusionsMethodological quality needs improvement in guidance documents on gout and hyperuricemia. Evidence for certain clinical questions is lacking, despite numerous trials in this field. Promoting standard guidance development methods and synthesising high-quality clinical evidence are potential approaches to reduce recommendation inconsistencies.PROSPERO registration numberCRD42016046104.

Section: Discussionsupporting

confidence: 88%

Diagnosis and treatment for hyperuricemia and gout: a systematic review of clinical practice guidelines and consensus statements

et al. 2019

BMJ Open

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123

“…Of the 17 CPGs, only ve reported >50% of the items in the RIGHT tool, suggesting that many were of low reporting quality. This nding is similar to that made previously using the AGREE tool [14].…”

Section: Discussionsupporting

confidence: 90%

Reporting Quality of Clinical Practice Guidelines Regarding Gout and Hyperuricemia According to the RIGHT checklist: Systematic Review

Luo²,

et al. 2021

Preprint

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Background The Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist was used to assess the reporting quality of 2009–2019 Clinical Practice Guidelines (CPGs) regarding gout and hyperuricemia, aimed to improve the reporting quality of future guidelines.Methods We searched PubMed, the Chinese Biomedical Literature database, the Wan Fang Database, and the China National Knowledge Infrastructure from January 2009 to June 2019 for guidelines regarding gout and hyperuricemia. We also searched the websites of guideline development organizations (the Guidelines International Network, the National Institute for Health and Clinical Excellence, the American College of Rheumatology, and the European League Against Rheumatism) (EULAR). Furthermore, supplementary guidelines reported in included articles were systematically searched, as well as Medlive and Google Scholar.Results Seventeen guidelines were included, of which one was in Chinese and 16 were in English. The mean reporting rate of the 35 items specified was 14.9 (42.5%), only five CPGs (29.4%) had a reporting rate >50%. Of the 35 items, three were very frequently reported. The reporting proportion of the seven domains (Basic information, Background, Evidence, Recommendations, Review and quality assurance, Funding and declaration and management of interests, and Other information) were 64.7%, 36.8%, 50.6% 50.6%, 42.9%, 8.82%, 33.8%, and 31.4%, respectively.Conclusion The reporting quality of the present guidelines for gout and hyperuricemia is relatively poor. We suggest that the RIGHT reporting checklist should be used by CPG developers to ensure higher reporting quality of future guidelines.

“…Of the 17 CPGs, only ve reported > 50% of the items in the RIGHT tool, suggesting that many were of low quality. This nding is similar to that made previously using the AGREE tool [13].…”

Section: Discussionsupporting

confidence: 90%

“…The quality of CPGs about gout and hyperuricemia were assessed before with AGREE II [5], whereas AGREE II and RIGHT checklist had unique items by themselves [16]; the RIGHT checklist added new and detailed items that AGREE II lacked. We assessed reporting quality of CPGs in the eld of gout and hyperuricemia, using the RIGHT checklist in our study, to help guideline developers better standardizing the reporting quality of future CPGs.…”

Section: Discussionmentioning

confidence: 99%

“…The RIGHT tool (supplementary material or http://www.right-statement.org) was used to evaluate the eligibility guidelines included in this study. The tool consists of 22 key items and 35 sub-items, which are divided into the following seven areas: Basic information (items 1-4), Background (items 5-9), Evidence (items [10][11][12], Recommendations (items [13][14][15], Review and quality assurance (items [16][17], Funding and declaration and management of interests (items [18][19], and Other information (items [20][21][22]. Each item was independently scored by two researchers, and most of the items were graded dichotomously, as "reported" (Y) or "unreported" (N).…”

Section: Reporting Quality Assessmentmentioning

confidence: 99%

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Reporting Quality of Clinical Practice Guidelines Regarding Gout and Hyperuricemia According to the Right Checklist

Luo²,

et al. 2020

Preprint

Self Cite

Objectives The Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist was used to assess the reporting quality of 2009–2019 Clinical Practice Guidelines (CPGs) regarding gout and hyperuricemia, aimed to improve the reporting quality of future guidelines.Methods We searched PubMed, the Chinese Biomedical Literature database, the Wan Fang Database, and the China National Knowledge Infrastructure from January 2009 to June 2019 for relevant guidelines. We also searched the websites of guideline development organizations (the Guidelines International Network, the National Institute for Health and Clinical Excellence, the American College of Rheumatology, and the European League Against Rheumatism) (EULAR). Furthermore, supplementary guidelines reported in included articles were systematically searched, as well as Medlive and Google Scholar. Results Seventeen guidelines were included, of which one was in Chinese and 16 were in English. The mean reporting rate of the 35 items specified was 14.9 (42.5%), only five CPGs (29.4%) had a reporting rate >50%. Of the 35 items, three were very frequently reported. The reporting proportion of the seven domains (Basic information, Background, Evidence, Recommendations, Review and quality assurance, Funding and declaration and management of interests, and Other information) were 64.7%, 36.8%, 50.6% 50.6%, 42.9%, 8.82%, 33.8%, and 31.4%, respectively.Conclusion The reporting quality of the present guidelines for gout and hyperuricemia is relatively poor. We suggest that the RIGHT reporting checklist should be used by CPG developers to ensure higher reporting quality of future guidelines.